4.  The applicant was born in 1970 and is serving a sentence of imprisonment in the Kurgan Region.
5.  He was arrested on 26 February 2009 in the town of Izhevsk on suspicion of drug trafficking.
6.  The applicant suffers from heroin addiction, chronic infectious endocariditis, tricuspid insufficiency and hepatitis C. From 27 February 2009 to 10 July 2010 he was detained in detention centre no. 18/1 in the Udmurtiya Region, and in hospitals for detainees.
7.  On 16 April 2009 the applicant sought release, referring to a deterioration in his health and the unavailability of medical assistance in the detention facility, which, in his submission, would lead to his death. He also claimed that he required urgent surgery. The investigator in charge of the criminal case dismissed the application for release, considering that before his arrest the applicant had had “enough time to obtain adequate medical care in the town of Perm as regards heart surgery”.
8.  On 23 April 2009 the Industrialniy District Court of Izhevsk examined the investigator’s request for the extension of the applicant’s detention. The court examined the defence’s arguments concerning his state of health, and concluded that they were insufficient grounds for dismissing the request since it had not been established that the applicant’s medical condition was incompatible with detention.
9.  Another extension request was examined on 16 July 2009. The court granted it, having concluded that there were no impediments to the applicant’s detention in a remand centre; the applicant’s medical condition, in itself, did not require release because the applicant had been, and continued to be, provided with medical care in detention. The nature of the treatment and compliance with it were not specified.
10.  While still in detention, the applicant was admitted to a hospital for treatment from 28 July to 20 August 2009 in connection with his chronic infectious endocarditis and tricuspid insufficiency.
11.  The criminal case against the applicant was submitted for trial in the District Court. On 25 August 2009 the applicant asked the judge to order a forensic expert examination to determine whether he needed in-patient treatment or surgery, and whether he was fit to participate in the court hearings.
12.  On the same day, the senior medical officer at the remand centre issued a certificate, indicating that the applicant’s medical condition was being monitored by the medical staff of the remand centre and no in-patient treatment in a hospital was required; a consultation by a cardiologist was to be provided “as scheduled”, or in the case of deterioration in the applicant’s medical condition.
13.  Having regard to the above certificate, the judge dismissed the applicant’s request. The judge considered that, as confirmed by the applicant, his state of health was satisfactory; the attending doctor had also stated that the applicant was fit to take part in the proceedings; and that he was being provided with medical care. The nature of the treatment and compliance with it were not specified.
14.  Apparently thereafter, the judge wrote to the administration of the remand centre where the applicant was then detained, requesting an opinion concerning the need for a forensic expert examination of the applicant by cardiologists and rheumatologists in order, eventually, to determine whether any surgery or hospitalisation was required; whether the applicant’s current state of health was compatible with detention; and whether the applicant was fit to take part in court hearings.
15.  In addition to the certificate of 25 August 2009, the senior medical officer of the remand centre wrote to the trial judge on 28 August 2009 indicating that the applicant did not require any urgent surgery, and that he was receiving out-patient monitoring by the medical staff of the remand centre and had four check-ups per year. The nature of the treatment and compliance with it were not specified.
16.  Medical assistance had to be provided to the applicant during court hearings on thirteen occasions between 24 August 2009 and 30 March 2010.
17.  On 12 October 2009 the presiding judge wrote to the remand centre inquiring whether the applicant was fit to continue with his participation in the trial hearings and whether a medical examination by cardiologists and rheumatologists was necessary. The remand centre replied on 19 October 2009 that the applicant was fit to participate in hearings but only if they were of a limited duration and held in a well-aired room. It was also stated that, noting the deterioration in the applicant’s health and the need to decide whether urgent surgery was necessary, the applicant should be examined by rheumatologists.
18.  On 13 November 2009 the district prosecutor’s office asked the trial judge to order an examination of the applicant by a cardiologist. The applicant suggested that the following issues be raised during such an examination: whether he needed in-patient treatment and urgent surgery (with an indication of the time-frame, in the case of an affirmative reply), and whether he was fit to participate in the trial and remain in a detention facility.
19.  On the same day, the trial judge commissioned an expert report, to be drawn up by the State office for forensic expertise. The expert was invited to determine whether the applicant was fit to participate in the trial (and under what conditions). The remaining issues raised by the applicant were dismissed as unrelated to the trial.
20.  On 30 November 2009 the applicant was examined by a cardio-rheumatologist, who adjusted his previous prescription for medication. Also in November 2009, the applicant had an echocardiogram and an electrocardiogram.
21.  A panel of medical professionals at the State office for forensic expertise issued the following expert report:
“... Having examined the available documents, we consider that [the applicant’s] heart disease is now in a phase of stable pathology and that he is fit to take part in court hearings under normal conditions (as regards microclimate and duration) with the necessary compliance with the recommendations made by the cardiologist on 30 November 2009, in particular as regards his intake of medication.”
22.  On 9 December 2009 a panel of medical professionals at prison hospital no. 8 also issued a report, which reads as follows:
“... In view of the degree of damage to the cardiac valves, and considering the possible consequences of their being affected, we recommend that detention be replaced by another preventive measure which will facilitate [the applicant’s] admission to a specialised cardiac hospital for surgery”.
23.  On 25 December 2009 the District Court examined the applicant’s renewed application for release. Having examined the above-mentioned medical reports, the court gave weight to the report of the State office for forensic expertise and maintained the applicant’s detention.
24.  On 7 April 2010 the applicant was convicted of drug trafficking and sentenced to five years and three months’ imprisonment.
25.  On 12 May 2010 the applicant was examined by a cardiologist.
26.  The applicant sought a consultative opinion from the Forensic Medicine and Law Unit of the St Petersburg Medical University as to the appropriate treatment and its availability in the detention facility. Having examined a number of documents (see paragraph 20 above), in their consultative opinion dated 11 June 2010 a group of three medical specialists made the following findings:
“Long-term prognosis in respect of infectious endocartitis is based, to a large extent, on the impairment of cardiac function ... The damage to the valvic structure of the heart ... discloses bi-ventricular (total) chronic heart decompensation, which is an aggravated type of heart decompensation. This is accompanied by pulmonary arterial hypertension, which is a factor of progressing heart decompensation ... We are unable to make any further findings regarding a prognosis because the most recent available material dates back to November 2009. However, it is clear that the disease will inevitably progress in the absence of adequate treatment.
As to treatment, the only radical method [for the applicant’s situation] is cardiac surgery. This method may only be ruled out where there is a medical contraindication to surgery ...
Under the relevant legal provisions, an in-patient examination in a specialised cardiac facility is necessary for deciding whether there is any such contraindication, and for determining the appropriate type of surgery and the corresponding timeframe and conditions ...
[The applicant] should no longer be treated in the medical unit of a detention facility because, under the relevant regulations, such a medical unit is suitable only for in-patient admission and care for no longer than fourteen days, for the temporary isolation of infectious patients, [and] for recovery treatment after discharge from a hospital ...”
27.  On 22 June 2010 the appeal court upheld the sentence and it became final.
28.  On 25 June 2010 the applicant’s medical record was sent to the Bakulev cardiac hospital in order to obtain a prescription for surgery, which is an instruction written by a medical practitioner that authorises a patient to be issued with treatment.
29.  On 27 June 2010 the prison medical unit issued a report stating that there were no contraindications to the surgery and recommending that it should be carried out in a specialised cardiology centre.
30.  On 10 or 11 July 2010 the applicant was transferred from prison no. 8 in the Udmurtiya Region, which apparently had an overpopulation problem, to prison no. 1 in the Kurgan Region. He arrived there on 29 July 2010 and was admitted to the tuberculosis unit of the prison. On the same day, the applicant’s mother received formal notification of the prescription for surgery from the cardiac hospital stating that the applicant should be admitted to it by 25 August 2010.
31.  In the meantime, on 14 July 2010 the applicant’s counsel brought proceedings under Chapter 25 of the Russian Code of Civil Procedure against detention centre no. 18/1 before the Pervomayskiy District Court of Izhevsk. The applicant argued that, despite the medical reports of 9 December 2009 and 11 June 2010 (see paragraphs 22 and 26 above), the staff of the detention facility had authorised his transfer to a detention facility in a distant region of Russia and failed to inform his relatives of his planned or actual transfer. The court noted that the applicable legislation required that a convicted person be detained in the region where he had been convicted or resided. He could be transferred to another region (i) in exceptional circumstances relating to his health or security, or at his own request; or (ii) if the right type of facility was not available or there was shortage of places in the region. In August 2010 the District Court rejected the applicant’s claims.
32.  On 9 August 2010 prison no. 1 received a “quota prescription” which allowed the applicant to be admitted to the Bakulev hospital for cardiac surgery in Moscow on 25 August 2010. On 10 August 2010 the detention facility asked the supervising prison department for permission to convey the applicant from Kurgan to Moscow. On 17 August 2010 the “operational unit” of the department gave its approval. However, since the approval of the “medical unit” of the department could not be obtained in time, the detention facility reached an agreement with the Bakulev hospital to re-schedule the applicant’s admission for 7 December 2010.
33.  According to the Government and an information note from prison no. 1, the tuberculosis unit had access to services provided by medical professionals at the regional cardiac hospital and the regional civic hospital.
34.  From October 2010 to an unspecified date in 2010 the applicant was kept in prison no. 2 in the Kurgan Region. Fresh approval was sought from the medical unit of the supervising prison department.
35.  On 8 December 2010 the medical staff of prison no. 1 concluded that the applicant “required to be conveyed to the Bakulev hospital in Moscow, the dates for transfer to be specified later on”. Apparently, at the request of the medical staff, the applicant’s admission to the cardiac hospital was rescheduled for 16 December 2010. It was subsequently rescheduled, for unspecified reasons, for 1 February 2011.
36.  According to the Government, “having detected violations of the law in relation to [the applicant’s] transfer to a medical facility, the regional prosecutor issued a decision and a warning to avoid similar shortcomings”.
37.  The Government submitted to the Court a certificate issued on 1 August 2011 by the acting director of prison no. 1 which stated that the applicant’s life was at no immediate risk and his disease was in remission.
38.  Between October 2011 and May 2012 the applicant was kept in the therapeutic unit of the hospital attached to Moscow detention centre no. 1.
39.  It can be seen from a certificate issued on 18 October 2011 by the Bakulev hospital that it was recommended that a coronary angiography be carried out and that the applicant undergo surgery with extracorporeal circulation.
40.  In a letter of 23 November 2011 the Bakulev hospital provided the following information to the Moscow remand centre:
“Surgery may be provided to [the applicant] in the Bakulev hospital under general conditions. His admission to the hospital is to include surgery with extracorporeal circulation in a sterile surgical unit, as well as the patient’s placement in a reanimation and intensive therapy unit during the immediate post-surgery period. This admission will also involve his subsequent presence in the surgery unit. The premises of the Bakulev hospital are not suitable for the admission of patients under a detention regime. The hospital cannot make arrangements for the treatment of [the applicant] under the supervision of four officers from your facility.”
41.  The Government submitted a certificate dated 2 August 2012 issued by the acting chief officer of prison no. 2. It reads as follows:
“... [The applicant] received a consultation from a cardiac surgeon from the Bakulev hospital in Moscow on 18 October 2011 ... Surgery with extracorporeal circulation was recommended (after a coronary angiography).
However, admission to the hospital was subsequently refused, owing to its inability to handle patients who were detainees.
On 29 May 2012 [the applicant] was seen by a cardiac surgeon from Moscow hospital no. 15. Surgery was not recommended because of the [applicant’s] stable condition, as well as on account of the high risk of complications during the post-surgery period while in detention.”
42.  There is no indication that thereafter there has been any significant change of the circumstances relating to the issue of medical care. It appears that the applicant is currently being kept in prison no. 2 in the Kurgan Region.